Hospital Managers’ Need for Information on Health Technology Investments

Abstract

Objectives: There is growing interest in implementing hospital-based health technology assessment (HB-HTA) as a tool to facilitate decision making based on a systematic and multidisciplinary assessment of evidence. However, the decision-making process, including the informational needs of hospital decision makers, is not well described. The objective was to review empirical studies analysing the information that hospital decision makers need when deciding about health technology (HT) investments.Methods: A systematic review of empirical studies published in English or Danish from 2000 to 2012 was carried out. The literature was assessed by two reviewers working independently. The identified informational needs were assessed with regard to their agreement with the nine domains of EUnetHTA's Core Model.Results: A total of 2,689 articles were identified and assessed. The review process resulted in 14 relevant studies containing 74 types of information that hospital decision makers found relevant. In addition to information covered by the Core Model, other types of information dealing with political and strategic aspects were identified. The most frequently mentioned types of information in the literature related to clinical, economic and political/strategic aspects. Legal, social, and ethical aspects were seldom considered most important.Conclusions: Hospital decision makers are able to describe their information needs when deciding on HT investments. The different types of information were not of equal importance to hospital decision makers, however, and full agreement between EUnetHTA's Core Model and the hospital decision-makers’ informational needs was not observed. They also need information on political and strategic aspects not covered by the Core Model.

Development of the WHO-INTEGRATE evidence-to-decision framework: an overview of systematic reviews of decision criteria for health decision-making

“…Six reviews were framed in the context of multi-criteria decision analysis [6,13,23,27,28,48]. Three reviews explored criteria used to guide investment or disinvestment decisions [22,27,37]. Two reviews assessed criteria to guide the selection of topics for HTA [8,34], and eight reviews captured criteria used in HTA [8,11,19,20,31,32,48].…”

“…Other reviews have explored the criteria employed in the context of health technology assessments (HTA), which intend to examine social, economic, organizational and ethical considerations in relation to health technologies in a comprehensive manner [30]; these covered both the criteria to inform decisions about health technologies by national or sub-national HTA institutions [19,[31][32][33], and the criteria used for selecting the technologies or interventions a HTA is to be conducted on [8,34]. In general, reviews have addressed criteria used for making decisions on funding or implementing health interventions or technologies [9,10,22,[35][36][37][38], prioritizing research topics [39][40][41] or coverage decisions [7,12,42,43]. Reviews include criteria used on various levels of decision making (national, regional, or local), in different contexts (e.g.…”

La evaluación de nuevas tecnologías en salud en hospitales: revisión narrativa

“…Sobre los criterios que deben tenerse en cuenta en el momento de hacer las evaluaciones, un estudio realizado de decisiones en salud hospitalaria según la relevancia de sus poblaciones particulares 39 .…”

“…Así, la diferencia fundamental entre los informes de ETS nacionales y hospitalarios, se explica de la siguiente manera: la ETS nacional necesita responder específicamente a las necesidades de información de los usuarios y entes territoriales, por ejemplo, un análisis de rentabilidad desde una perspectiva social, mientras que las evaluaciones económicas hospitalarias deben proporcionar un análisis de rentabilidad con la perspectiva del hospital propiamente y requiere la presentación de un análisis de impacto económico en las instituciones 39 .…”

Multiple criteria decision analysis approach to consider therapeutic innovations in the emergency department: The methoxyflurane organizational impact in acute trauma pain

“…In the complex organizational context of emergency medicine, it therefore appears that the choice of an analgesic strategy cannot be exclusively based on clinical and health economics criteria-the criteria most commonly used to consider innovations in healthcare [14,15]. Importantly, failure to take account of a potential organizational impact will bias the assessment of a healthcare innovation, and will mean that (i) care resources as a whole are not optimized, and (ii) the cost/benefit ratio could disadvantage the institution.…”